Dumping Syndrome. Information for patients Sheffield Dietetics

Transcription

1 Dumping Syndrome Information for patients Sheffield Dietetics

2 page 2 of 8

3 What is dumping syndrome? Dumping syndrome is a group of symptoms that may result from having part of or all of your stomach removed, or from other surgery involving the stomach. Dumping syndrome is common after gastric surgery, with 20-50% of people experiencing it. The symptoms range from mild to severe and often reduce or improve with time, as your bowel adapts. Although you may find dumping syndrome alarming at first, it is not life threatening. You can help to control it by making changes to what and how you eat. What causes dumping syndrome? After gastric surgery, it can be more difficult to regulate the movement of food, which rushes too quickly into the small bowel. There are two types of dumping syndrome: early dumping syndrome and late dumping syndrome. Each of these has different causes and different symptoms, but are treated in the same way. Causes of early dumping syndrome Early dumping syndrome happens because food is rapidly rushing or "dumping" into the small bowel. This can cause the following: The small bowel stretches, creating a feeling of fullness, discomfort and nausea. Water is pulled out of the bloodstream and moves into the small bowel causing a drop in blood pressure which can make you feel faint or dizzy. The presence of more fluid in your bowel also causes it to contract more and can make you feel bloated and give you watery diarrhoea. Hormones released from the small bowel into the bloodstream affect blood pressure, causing it to drop and this can make you feel faint or dizzy. page 3 of 8

4 Causes of late dumping syndrome Late dumping syndrome is caused by foods that are high in carbohydrate (foods that contain starch or sugar) rushing or dumping into the small bowel. This causes a rise in blood sugar levels as the carbohydrate is absorbed into your bloodstream. Your body responds by producing large amounts of insulin. Insulin is a hormone that helps keep blood sugar at normal levels so your body can work properly. Insulin s job is to help sugar enter your cells where it s used for energy. This extra insulin therefore causes your blood sugar levels to fall as the sugar moves into your cells and insulin levels continue to rise after the blood sugar levels have begun to fall. It is this high insulin level and low blood sugar level that causes the symptoms. page 4 of 8

5 What are the symptoms? Symptoms of early dumping syndrome This usually happens about 30 to 60 minutes after you eat. Symptoms normally last between 10 minutes and 1 hour and may include: A feeling of fullness, even after eating just a small amount Abdominal cramping or pain Nausea or vomiting Severe diarrhoea Sweating, flushing, or light-headedness Rapid heartbeat Symptoms of late dumping syndrome This normally happens about 1 to 3 hours after eating, or when a meal has been missed, and may include: Fatigue or weakness Flushing or sweating Shakiness, dizziness, fainting, or passing out Loss of concentration or mental confusion Feelings of hunger Rapid heartbeat page 5 of 8

6 How is dumping syndrome treated? Many people find that taking the following steps helps to prevent or reduce symptoms of dumping syndrome. Eat five or six smaller meals or snacks a day aim to eat every 2-3 hours Cut food into small pieces and chew well before swallowing Choose starchy (complex) carbohydrates, such as potatoes, cereals, pasta, rice and bread, instead of refined sugary foods and drinks like sweets, biscuits, cakes and pastries Make sure you have small portions of regular starchy carbohydrates throughout the day Combine proteins (meat, fish, eggs, nuts, beans & pulses) or fats along with fruits or starchy foods (bread, rice, pasta, cereals), for example cheese on toast or peanut butter on crackers Don t eat sweet foods on an empty stomach if you want to have a little bit of something sweet have a small amount at the end of a meal Use sugar replacements, such as Splenda, Equal, or Sweet'N Low, instead of sugar Stop eating when you first begin to feel full have a rest and come back to it if you need to Try not to drink liquids when eating - wait 30 to 45 minutes after meals To prevent dehydration, drink more than 6 cups of water or other sugar-free, decaffeinated, non-carbonated drinks throughout the day Avoid very hot or cold foods Reclining after eating may help prevent light-headedness Using fibre supplements, such as psyllium, methylcellulose (Celevac), or guar gum (Benefiber) may help to slow down the page 6 of 8

7 passage of food through your bowel. Your doctor, dietitian or pharmacist can advise you on this matter Alcohol may make your symptoms of dumping syndrome worse, so it is best avoided If you are struggling to maintain your weight add extra butter, cream or cheese to the foods you are having and try to include milky drinks through the day. More information is available on this from your dietitian Who should I contact if I have any concerns? It is important to manage dumping syndrome so you stay well-nourished and do not lose too much weight. Talk to your surgeon or dietitian about any symptoms you have and what else you can do. In some cases, medication or surgery may help correct the symptoms of dumping syndrome. page 7 of 8

8 Produced with support from Sheffield Hospitals Charity Working together we can help local patients feel even better To donate visit Registered Charity No Alternative formats can be available on request. Please Sheffield Teaching Hospitals NHS Foundation Trust 2018 Re-use of all or any part of this document is governed by copyright and the Re-use of Public Sector Information Regulations 2005 SI 2005 No Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. PD7983-PIL3341 v3 Issue Date: July Review Date: July 2021